A Pilot Study of Hemoglobin A1C Levels in Patients with Type 2 Diabetes after Creation of a Patient Assistance Program Enrollment Committee at a Student-Run Free Clinic
Background: Our student-run free clinic (SRFC) treats uninsured patients with type 2 diabetes (T2D) in a medically underserved region. Mississippi has the second highest diabetes prevalence in the nation. Increasing access for patients with diabetes to affordable medication is challenging. Some stu...
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University of Minnesota Libraries Publishing
2025-01-01
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| Series: | INNOVATIONS in Pharmacy |
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| Online Access: | https://pubs.lib.umn.edu/index.php/innovations/article/view/6435 |
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| author | John D. Salvemini Gregory R. Vance Amanda Pham Garner Fincher Johnny Yang Harshin Sanjanwala Leonna Conley Alan Penman James Pitcock |
| author_facet | John D. Salvemini Gregory R. Vance Amanda Pham Garner Fincher Johnny Yang Harshin Sanjanwala Leonna Conley Alan Penman James Pitcock |
| author_sort | John D. Salvemini |
| collection | DOAJ |
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Background: Our student-run free clinic (SRFC) treats uninsured patients with type 2 diabetes (T2D) in a medically underserved region. Mississippi has the second highest diabetes prevalence in the nation. Increasing access for patients with diabetes to affordable medication is challenging. Some studies provide encouraging results for lowering hemoglobin A1C and increasing medication adherence through patient assistance programs (PAP). None have examined a student-run PAP committee’s impact on diabetes outcomes.
Objective: To compare A1C levels for patients with diabetes enrolled in PAPs by our committee with those not enrolled and to describe clinical outcomes.
Methods: A retrospective review of patients with T2D at our SRFC between 2015 and 2023 was performed. The primary outcome was change in A1C within a 4-9 month follow-up window. Secondary outcomes were emergency department (ED) visits and hospital admissions.
Results: Twenty-five patients with T2D were enrolled in PAPs, while 77 were not. The PAP group had a higher baseline A1C (10.9% vs. 8.7%). The difference in A1C between groups was not statistically significant (P=0.68), even with adjustment for covariates (P=0.59). ED visit and hospital admission frequency was similar between groups. Neuropathy was the most common diabetic complication. ED visits and hospital admissions for heart attacks occurred only in the non-PAP group.
Conclusion: While patients enrolled in PAPs showed a greater average reduction in A1C, the difference was not statistically significant. The higher baseline A1C in the PAP group carries greater reduction potential. A prospective study is necessary to better evaluate PAP enrollment outcomes for uninsured patients with diabetes.
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| format | Article |
| id | doaj-art-9a167b2cfad34cd28ba59d8df5f22964 |
| institution | Kabale University |
| issn | 2155-0417 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | University of Minnesota Libraries Publishing |
| record_format | Article |
| series | INNOVATIONS in Pharmacy |
| spelling | doaj-art-9a167b2cfad34cd28ba59d8df5f229642025-02-09T21:38:37ZengUniversity of Minnesota Libraries PublishingINNOVATIONS in Pharmacy2155-04172025-01-0115410.24926/iip.v15i4.6435A Pilot Study of Hemoglobin A1C Levels in Patients with Type 2 Diabetes after Creation of a Patient Assistance Program Enrollment Committee at a Student-Run Free ClinicJohn D. Salvemini0Gregory R. Vance1Amanda Pham2Garner Fincher3Johnny Yang4Harshin Sanjanwala5Leonna Conley6Alan Penman7James Pitcock8University of Mississippi Medical CenterUniversity of Mississippi Medical CenterUniversity of Mississippi Medical CenterUniversity of Mississippi Medical CenterUniversity of Mississippi Medical CenterUniversity of Mississippi Medical CenterUniversity of Mississippi Medical CenterUniversity of Mississippi Medical CenterUniversity of Mississippi Background: Our student-run free clinic (SRFC) treats uninsured patients with type 2 diabetes (T2D) in a medically underserved region. Mississippi has the second highest diabetes prevalence in the nation. Increasing access for patients with diabetes to affordable medication is challenging. Some studies provide encouraging results for lowering hemoglobin A1C and increasing medication adherence through patient assistance programs (PAP). None have examined a student-run PAP committee’s impact on diabetes outcomes. Objective: To compare A1C levels for patients with diabetes enrolled in PAPs by our committee with those not enrolled and to describe clinical outcomes. Methods: A retrospective review of patients with T2D at our SRFC between 2015 and 2023 was performed. The primary outcome was change in A1C within a 4-9 month follow-up window. Secondary outcomes were emergency department (ED) visits and hospital admissions. Results: Twenty-five patients with T2D were enrolled in PAPs, while 77 were not. The PAP group had a higher baseline A1C (10.9% vs. 8.7%). The difference in A1C between groups was not statistically significant (P=0.68), even with adjustment for covariates (P=0.59). ED visit and hospital admission frequency was similar between groups. Neuropathy was the most common diabetic complication. ED visits and hospital admissions for heart attacks occurred only in the non-PAP group. Conclusion: While patients enrolled in PAPs showed a greater average reduction in A1C, the difference was not statistically significant. The higher baseline A1C in the PAP group carries greater reduction potential. A prospective study is necessary to better evaluate PAP enrollment outcomes for uninsured patients with diabetes. https://pubs.lib.umn.edu/index.php/innovations/article/view/6435patient assistance programstudent-run free clinicdiabetes |
| spellingShingle | John D. Salvemini Gregory R. Vance Amanda Pham Garner Fincher Johnny Yang Harshin Sanjanwala Leonna Conley Alan Penman James Pitcock A Pilot Study of Hemoglobin A1C Levels in Patients with Type 2 Diabetes after Creation of a Patient Assistance Program Enrollment Committee at a Student-Run Free Clinic INNOVATIONS in Pharmacy patient assistance program student-run free clinic diabetes |
| title | A Pilot Study of Hemoglobin A1C Levels in Patients with Type 2 Diabetes after Creation of a Patient Assistance Program Enrollment Committee at a Student-Run Free Clinic |
| title_full | A Pilot Study of Hemoglobin A1C Levels in Patients with Type 2 Diabetes after Creation of a Patient Assistance Program Enrollment Committee at a Student-Run Free Clinic |
| title_fullStr | A Pilot Study of Hemoglobin A1C Levels in Patients with Type 2 Diabetes after Creation of a Patient Assistance Program Enrollment Committee at a Student-Run Free Clinic |
| title_full_unstemmed | A Pilot Study of Hemoglobin A1C Levels in Patients with Type 2 Diabetes after Creation of a Patient Assistance Program Enrollment Committee at a Student-Run Free Clinic |
| title_short | A Pilot Study of Hemoglobin A1C Levels in Patients with Type 2 Diabetes after Creation of a Patient Assistance Program Enrollment Committee at a Student-Run Free Clinic |
| title_sort | pilot study of hemoglobin a1c levels in patients with type 2 diabetes after creation of a patient assistance program enrollment committee at a student run free clinic |
| topic | patient assistance program student-run free clinic diabetes |
| url | https://pubs.lib.umn.edu/index.php/innovations/article/view/6435 |
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